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Di Pietro G, Cioffi E, Falco P, Galosi E, De Stefano G, Di Stefano G, Leone C, Martines V, Perotti S, Casali C, Truini A. Nerve ultrasound in Friedreich's Ataxia: enlarged nerves as a biomarker of disease severity. Clin Neurophysiol 2024; 159:75-80. [PMID: 38359552 DOI: 10.1016/j.clinph.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 01/28/2024] [Indexed: 02/17/2024]
Abstract
OBJECTIVE In Friedreich's ataxia research, the focus is on discovering treatments and biomarkers to assess disease severity and treatment effects. Our study examines high-resolution nerve ultrasound in these patients, seeking correlations with established clinical markers of disease severity. METHOD Ten patients with Friedreich's Ataxia underwent a comprehensive clinical assessment with established scales (SARA, FARS, mFARS, INCAT, ADL 0-36, IADL). Additionally, they underwent nerve conduction studies and high-resolution nerve ultrasound. Quantitative evaluation of nerve cross-sectional area, conducted at 24 nerve sites using high-resolution nerve ultrasound, was compared with data obtained from 20 healthy volunteers. RESULTS All the patients had a severe sensory axonal neuropathy. High-resolution nerve ultrasound showed significant increase, in cross sectional area, of median and ulnar nerves at the axilla and arm. The cumulative count of affected nerve sites was directly associated with clinical disability, as determined by SARA, FARS, mFARS, ADL 0-36, and INCAT score, while displaying an inverse correlation with IADL. CONCLUSIONS Our study shows that high-resolution ultrasound reveals notable nerve abnormalities, primarily in the upper limbs of patients diagnosed with Friedreich's Ataxia. The observed correlation between these nerve abnormalities and clinical disability scales indicates the potential use of this technique as a biomarker for evaluating disease severity and treatment effects. SIGNIFICANCE Nerve Ultrasound is a potential biomarker of disease severity in Friedreich's Ataxia.
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Affiliation(s)
- G Di Pietro
- Department of Human Neuroscience, Sapienza University, Rome, Italy.
| | - E Cioffi
- Department of Medico-Surgical Sciences and Biotechnologies, University of Rome Sapienza, Latina, Italy
| | - P Falco
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - E Galosi
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - G De Stefano
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - G Di Stefano
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - C Leone
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - V Martines
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Italy; UOC Neuroradiologia, Policlinico Umberto I, Roma, Italy
| | - S Perotti
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Italy; UOC Neuroradiologia, Policlinico Umberto I, Roma, Italy
| | - C Casali
- Department of Medico-Surgical Sciences and Biotechnologies, University of Rome Sapienza, Latina, Italy
| | - A Truini
- Department of Human Neuroscience, Sapienza University, Rome, Italy
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Di Pietro G, Falco P, D'Elia C, Cavalcanti L, De Stefano G, Di Stefano G, Fabiano E, Galosi E, Leone C, Vicenzini E, Truini A, Mancini P. Predicting value for incomplete recovery in Bell's palsy of facial nerve ultrasound versus nerve conduction study. Clin Neurophysiol 2024; 158:35-42. [PMID: 38150916 DOI: 10.1016/j.clinph.2023.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 11/07/2023] [Accepted: 11/29/2023] [Indexed: 12/29/2023]
Abstract
OBJECTIVE This longitudinal study aims at assessing the predictive value of facial nerve high-resolution ultrasound (HRUS) for incomplete clinical recovery in patients with Bell's palsy, the most common facial nerve disease. METHODS We prospectively enrolled 34 consecutive patients with Bell's palsy. All patients underwent neurophysiological testing (including facial nerve conduction study) and HRUS evaluations 10-15 days (T1), one month (T2), and three months (T3) after the onset of Bell's palsy. Patients who did not experience complete recovery within three months were also evaluated after six months (T4). We have then compared the accuracy of HRUS with that of the facial nerve conduction study in predicting incomplete clinical recovery at three and six months. RESULTS At T1, the facial nerve diameter, as assessed with HRUS, was larger on the affected side than on the normal side, particularly in patients with incomplete recovery at T2, T3 and T4. ROC curve analysis, however, showed that the facial nerve diameter at T1 had a lower predictive value than the facial nerve conduction study for an incomplete clinical recovery at three (T3) and six (T4) months. Still, the facial nerve diameter asymmetry, as assessed with HRUS, had a relatively high negative predictive value (thus indicating a strong association between normal HRUS examination and a good prognosis). CONCLUSIONS Although HRUS shows abnormally increased facial nerve diameter in patients in the acute phase of Bell's palsy, the predictive value of this technique for incomplete clinical recovery at three and six months is lower than that of the nerve conduction study. SIGNIFICANCE Nerve ultrasound has a low predictive value for incomplete clinical recovery in patients with Bell's Palsy.
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Affiliation(s)
- G Di Pietro
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - P Falco
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - C D'Elia
- Department of Sense Organs, Sapienza University, Rome, Italy
| | - L Cavalcanti
- Department of Sense Organs, Sapienza University, Rome, Italy
| | - G De Stefano
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - G Di Stefano
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - E Fabiano
- Department of Sense Organs, Sapienza University, Rome, Italy
| | - E Galosi
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - C Leone
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - E Vicenzini
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - A Truini
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy.
| | - P Mancini
- Department of Sense Organs, Sapienza University, Rome, Italy
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Leone C, Di Pietro G, Salman Y, Galosi E, Di Stefano G, Caspani O, Garcia-Larrea L, Mouraux A, Treede RD, Truini A. Modulation of the spinal N13 SEP component by high- and low-frequency electrical stimulation. Experimental pain models matter. Clin Neurophysiol 2023; 156:28-37. [PMID: 37856896 DOI: 10.1016/j.clinph.2023.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/15/2023] [Accepted: 08/31/2023] [Indexed: 10/21/2023]
Abstract
OBJECTIVE The N13 component of somatosensory evoked potential (N13 SEP) represents the segmental response of cervical dorsal horn neurons. Neurophysiological studies in healthy participants showed that capsaicin-induced central sensitization causes an increase of the N13 SEP amplitude. Consequently, in human research, this spinal component may serve as a valuable readout of central sensitization. In this study, we wanted to verify if the sensitivity of the N13 SEP for detecting central sensitization is consistent across different experimental pain models inducing central sensitization and secondary hyperalgesia, namely high and low-frequency electrical stimulation (HFS and LFS). METHODS In 18 healthy participants, we recorded SEP after bilateral ulnar nerve stimulation before and after secondary hyperalgesia was induced through HFS and LFS applied on the ulnar nerve territory of the hand of one side. The area of secondary hyperalgesia was mapped with a calibrated 128-mN pinprick probe, and the mechanical pain sensitivity with three calibrated 16-64-256-mN pinprick probes. RESULTS Although both HFS and LFS successfully induced secondary hyperalgesia only LFS increased the amplitude of the N13 SEP. CONCLUSIONS These findings suggest that the sensitivity of the N13 SEP for detecting dorsal horn excitability changes may critically depend on the different experimental pain models. SIGNIFICANCE Our results indicate that LFS and HFS could trigger central sensitization at the dorsal horn level through distinct mechanisms, however this still needs confirmation by replication studies.
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Affiliation(s)
- C Leone
- Department of Human Neuroscience, Sapienza University of Rome, Italy.
| | - G Di Pietro
- Department of Human Neuroscience, Sapienza University of Rome, Italy
| | - Y Salman
- Université Catholique de Louvain, Institute of Neuroscience (IoNS), Faculty of Medicine, Bruxelles, Belgium
| | - E Galosi
- Department of Human Neuroscience, Sapienza University of Rome, Italy
| | - G Di Stefano
- Department of Human Neuroscience, Sapienza University of Rome, Italy
| | - O Caspani
- Department of Neurophysiology, Center for Biomedicine and Medical Technology Mannheim (CBTM), Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany
| | - L Garcia-Larrea
- Lyon Neurosciences Center Research Unit Inserm U 1028, Pierre Wertheimer Hospital, Hospices Civils de Lyon, Lyon 1 University, Lyon, France
| | - A Mouraux
- Université Catholique de Louvain, Institute of Neuroscience (IoNS), Faculty of Medicine, Bruxelles, Belgium
| | - R-D Treede
- Department of Neurophysiology, Center for Biomedicine and Medical Technology Mannheim (CBTM), Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany
| | - A Truini
- Department of Human Neuroscience, Sapienza University of Rome, Italy
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Zangirolami-Raimundo J, Raimundo RD, Silva Noll PRE, Dos Santos WS, Leone C, Baracat EC, Sorpreso ICE, Soares Júnior JM. Postmenopausal women's cognitive function and performance of virtual reality tasks. Climacteric 2023; 26:445-454. [PMID: 36999579 DOI: 10.1080/13697137.2023.2190511] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/28/2023] [Accepted: 03/04/2023] [Indexed: 04/01/2023]
Abstract
OBJECTIVE This study aimed to assess whether prior knowledge of computer use determines performance of virtual reality tasks by postmenopausal women and whether menopausal symptoms, sociodemographic factors, lifestyle and cognition modify or interfere with their performance. METHOD This cross-sectional study included 152 postmenopausal women divided into two groups: computer users and non-users. Age, ethnicity, time of menopause, menopausal symptoms, female health status, level of physical activity and cognitive function were considered. The participants played a virtual reality game and were assessed for hits, errors, omissions and game time. The Mann-Whitney, chi-square and Fisher exact tests and multivariate linear regression analysis were used. RESULTS Postmenopausal computer users play virtual reality games (p = 0.005) better than postmenopausal non-users of computers. Vasomotor symptoms were high in women who used computers compared to those who did not (p = 0.006). Multivariate linear regression analysis found that the best-fitting predictors for the number of hits - that is, age (p = 0.039), Mini-Mental State Examination score (p = 0.006) and the headache symptom (p = 0.021) - influence the performance of virtual reality tasks. CONCLUSION Computer users performed virtual reality tasks better than non-users. Headache and age but not vasomotor symptoms negatively affected the postmenopausal women's performance.
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Affiliation(s)
- J Zangirolami-Raimundo
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
- Centro Universitário FMABC, São Paulo, Brazil
| | - R D Raimundo
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
- Centro Universitário FMABC, São Paulo, Brazil
| | - P R E Silva Noll
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - W S Dos Santos
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
- Centro Universitário FMABC, São Paulo, Brazil
| | - C Leone
- Centro Universitário FMABC, São Paulo, Brazil
| | - E C Baracat
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - I C E Sorpreso
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - J M Soares Júnior
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
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Orzan N, Leone C, Mazzolini A, Oyero J, Celani A. Optimizing airborne wind energy with reinforcement learning. Eur Phys J E Soft Matter 2023; 46:2. [PMID: 36656364 DOI: 10.1140/epje/s10189-022-00259-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 12/29/2022] [Indexed: 06/17/2023]
Abstract
Airborne wind energy is a lightweight technology that allows power extraction from the wind using airborne devices such as kites and gliders, where the airfoil orientation can be dynamically controlled in order to maximize performance. The dynamical complexity of turbulent aerodynamics makes this optimization problem unapproachable by conventional methods such as classical control theory, which rely on accurate and tractable analytical models of the dynamical system at hand. Here we propose to attack this problem through reinforcement learning, a technique that-by repeated trial-and-error interactions with the environment-learns to associate observations with profitable actions without requiring prior knowledge of the system. We show that in a simulated environment reinforcement learning finds an efficient way to control a kite so that it can tow a vehicle for long distances. The algorithm we use is based on a small set of intuitive observations and its physically transparent interpretation allows to describe the approximately optimal strategy as a simple list of manoeuvring instructions.
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Affiliation(s)
- N Orzan
- The Abdus Salam International Center for Theoretical Physics ICTP, 34151, Trieste, Italy
- University of Groningen, 9700, Groningen, AB, The Netherlands
| | - C Leone
- The Abdus Salam International Center for Theoretical Physics ICTP, 34151, Trieste, Italy
- SISSA International School for Advanced Studies, 34136, Trieste, Italy
| | - A Mazzolini
- The Abdus Salam International Center for Theoretical Physics ICTP, 34151, Trieste, Italy
- Laboratoire de physique de l'École normale supérieure (PSL University), CNRS, Sorbonne Université, and Université de Paris, 75005, Paris, France
| | - J Oyero
- The Abdus Salam International Center for Theoretical Physics ICTP, 34151, Trieste, Italy
- Nonlinear Physical Chemistry Unit, Service de Chimie Physique et Biologie Théorique, Université Libre de Bruxelles, CP 231 - Campus Plaine, 1050, Brussels, Belgium
| | - A Celani
- The Abdus Salam International Center for Theoretical Physics ICTP, 34151, Trieste, Italy.
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Leone C, Di Lionardo A, Di Pietro G, Di Stefano G, Falco P, Blockeel A, Caspani O, Garcia-Larrea L, Mouraux A, Phillips K, Treede R, Truini A. Erratum to “How different experimental models of secondary hyperalgesia change the nociceptive flexion reflex” [Clin. Neurophysiol. 132 (2021) 2989–2995]. Clin Neurophysiol 2022; 145:162. [DOI: 10.1016/j.clinph.2022.07.499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Galosi E, Falco P, Di Pietro G, Leone C, Esposito N, De Stefano G, Di Stefano G, Truini A. The diagnostic accuracy of the Small Fiber Neuropathy Symptoms Inventory Questionnaire (SFN-SIQ) for identifying pure small fiber neuropathy. J Peripher Nerv Syst 2022; 27:283-290. [PMID: 36175394 PMCID: PMC10092576 DOI: 10.1111/jns.12513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/08/2022] [Accepted: 09/21/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND AND AIMS A definite diagnosis of pure small fiber neuropathy (SFN) relies on specific diagnostic testing, such as skin biopsy, quantitative sensory testing (QST), and nociceptive evoked potentials, which require considerable resources that may not be widely available. Accordingly, diagnostic tools with easy implementation in non-specialist centers are warranted to identify patients who require second-level diagnostic tests. In this study, we aimed to test the accuracy of the Small Fiber Neuropathy Symptoms Inventory Questionnaire (SFN-SIQ) in diagnosing pure SFN. METHODS We enrolled 86 patients with suspected pure SFN. In these patients, we calculated the diagnostic accuracy of the SFN-SIQ using a combination of clinical examination, quantitative sensory testing, and skin biopsy as a reference standard. RESULTS We found that the SFN-SIQ showed an excellent ability to discriminate between patients with and without pure SFN, with 86% sensitivity and 70% specificity in the diagnosis of pure SFN. INTERPRETATION Our study providing the diagnostic yield of the SFN-SIQ for pure SFN diagnosis suggests that this questionnaire might be used to screen patients with suspected SFN and identify those requiring second-level diagnostic tests such as QST, skin biopsy, or nociceptive evoked potentials. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- E Galosi
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - P Falco
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - G Di Pietro
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - C Leone
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - N Esposito
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - G De Stefano
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - G Di Stefano
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - A Truini
- Department of Human Neuroscience, Sapienza University, Rome, Italy
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Leone C, Di Lionardo A, Di Pietro G, Di Stefano G, Falco P, Blockeel AJ, Caspani O, Garcia-Larrea L, Mouraux A, Phillips KG, Treede RD, Truini A. How different experimental models of secondary hyperalgesia change the nociceptive flexion reflex. Clin Neurophysiol 2021; 132:2989-2995. [PMID: 34715423 DOI: 10.1016/j.clinph.2021.08.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 08/05/2021] [Accepted: 08/29/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE In this neurophysiological study in healthy humans, we assessed how central sensitization induced by either high-frequency stimulation (HFS) or topical capsaicin application modulates features of the RIII reflex response. The ability of these stimuli to engage the endogenous pain modulatory system was also tested. METHODS In 26 healthy participants we elicited an RIII reflex using suprathreshold stimulation of the sural nerve. Subsequently HFS or capsaicin were applied to the foot and the RIII reflex repeated after 15 minutes. Contact heating of the volar forearm served as the heterotopic test stimulus to probe activation of the endogenous pain modulatory system. RESULTS HFS significantly reduced the pain threshold by 29% and the RIII reflex threshold by 20%. Capsaicin significantly reduced the pain threshold by 17% and the RIII reflex threshold by 18%. Both HFS and capsaicin left RIII reflex size unaffected. Numerical Rating Scale (NRS) pain scores elicited by the heterotopic noxious heat stimulus were unaffected by capsaicin and slightly increased by HFS. CONCLUSIONS HFS and capsaicin similarly modulated the pain threshold and RIII reflex threshold, without a concomitant inhibitory effect of the endogenous pain modulatory system. SIGNIFICANCE Our neurophysiological study supports the use of the RIII reflex in investigating central sensitization in humans.
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Affiliation(s)
- C Leone
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - A Di Lionardo
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - G Di Pietro
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - G Di Stefano
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - P Falco
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - A J Blockeel
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK
| | - O Caspani
- Department of Neurophysiology, Center for Biomedicine and Medical Technology Mannheim (CBTM), Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany
| | - L Garcia-Larrea
- Lyon Neurosciences Center Research Unit Inserm U 1028, Pierre Wertheimer Hospital, Hospices Civils de Lyon, Lyon 1 University, Lyon, France; Pain Center, Pierre Wertheimer Hospital, Hospices Civils de Lyon, Lyon 1 University, Lyon, France
| | - A Mouraux
- Université Catholique de Louvain, Institute of Neuroscience (IoNS), Faculty of Medicine, Bruxelles, Belgium
| | - K G Phillips
- Lilly United Kingdom Erl Wood Manor Windlesham, Surrey, United Kingdom
| | - R D Treede
- Department of Neurophysiology, Center for Biomedicine and Medical Technology Mannheim (CBTM), Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany
| | - A Truini
- Department of Human Neuroscience, Sapienza University, Rome, Italy.
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Di Lionardo A, Di Stefano G, Leone C, Di Pietro G, Sgro E, Malara E, Cosentino C, Mollica C, Blockeel AJ, Caspani O, Garcia-Larrea L, Mouraux A, Treede RD, Phillips KG, Valeriani M, Truini A. Modulation of the N13 component of the somatosensory evoked potentials in an experimental model of central sensitization in humans. Sci Rep 2021; 11:20838. [PMID: 34675309 PMCID: PMC8531029 DOI: 10.1038/s41598-021-00313-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 10/01/2021] [Indexed: 11/09/2022] Open
Abstract
The N13 component of somatosensory evoked potential (N13 SEP) represents the segmental response of dorsal horn neurons. In this neurophysiological study, we aimed to verify whether N13 SEP might reflect excitability changes of dorsal horn neurons during central sensitization. In 22 healthy participants, we investigated how central sensitization induced by application of topical capsaicin to the ulnar nerve territory of the hand dorsum modulated N13 SEP elicited by ulnar nerve stimulation. Using a double-blind placebo-controlled crossover design, we also tested whether pregabalin, an analgesic drug with proven efficacy on the dorsal horn, influenced capsaicin-induced N13 SEP modulation. Topical application of capsaicin produced an area of secondary mechanical hyperalgesia, a sign of central sensitization, and increased the N13 SEP amplitude but not the peripheral N9 nor the cortical N20-P25 amplitude. This increase in N13 SEP amplitude paralleled the mechanical hyperalgesia and persisted for 120 min. Pregabalin prevented the N13 SEP modulation associated with capsaicin-induced central sensitization, whereas capsaicin application still increased N13 SEP amplitude in the placebo treatment session. Our neurophysiological study showed that capsaicin application specifically modulates N13 SEP and that this modulation is prevented by pregabalin, thus suggesting that N13 SEP may reflect changes in dorsal horn excitability and represent a useful biomarker of central sensitization in human studies.
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Affiliation(s)
- A Di Lionardo
- Department of Human Neuroscience, University Sapienza, Viale Università 30, 00185, Rome, Italy
| | - G Di Stefano
- Department of Human Neuroscience, University Sapienza, Viale Università 30, 00185, Rome, Italy
| | - C Leone
- Department of Human Neuroscience, University Sapienza, Viale Università 30, 00185, Rome, Italy
| | - G Di Pietro
- Department of Human Neuroscience, University Sapienza, Viale Università 30, 00185, Rome, Italy
| | - E Sgro
- Department of Human Neuroscience, University Sapienza, Viale Università 30, 00185, Rome, Italy
| | - E Malara
- Department of Human Neuroscience, University Sapienza, Viale Università 30, 00185, Rome, Italy
| | - C Cosentino
- Department of Human Neuroscience, University Sapienza, Viale Università 30, 00185, Rome, Italy
| | - C Mollica
- Department of Statistical Sciences, Sapienza University, Rome, Italy
| | - A J Blockeel
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK
| | - O Caspani
- Department of Neurophysiology, Mannheim Center for Translational Neurosciences (MCTN), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - L Garcia-Larrea
- Lyon Neurosciences Center Research Unit Inserm U 1028, Pierre Wertheimer Hospital, Hospices Civils de Lyon, Lyon 1 University, Lyon, France.,Pain Center, Pierre Wertheimer Hospital, Hospices Civils de Lyon, Lyon 1 University, Lyon, France
| | - A Mouraux
- UCLouvain, Institute of Neuroscience (IoNS), Brussels, Belgium
| | - R D Treede
- Department of Neurophysiology, Mannheim Center for Translational Neurosciences (MCTN), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - K G Phillips
- Neuroscience Next Generation Therapeutics, Eli Lilly and Company, Lilly Innovation Center, Cambridge, MA, 02142, USA
| | - M Valeriani
- Department of Neuroscience, Headache Center, Bambino Gesù Children's Hospital, Rome, Italy.,Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark
| | - Andrea Truini
- Department of Human Neuroscience, University Sapienza, Viale Università 30, 00185, Rome, Italy.
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Vaddu S, Kataria J, Belem TS, Sidhu G, Moller AE, Leone C, Singh M, Thippareddi H. On-site generated peroxy acetic acid (PAA) technology reduces Salmonella and Campylobacter on chicken wings. Poult Sci 2021; 100:101206. [PMID: 34111613 PMCID: PMC8192870 DOI: 10.1016/j.psj.2021.101206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/05/2021] [Accepted: 04/11/2021] [Indexed: 11/17/2022] Open
Abstract
Peroxyacetic acid (PAA) is a widely used antimicrobial during poultry processing that requires to be shipped in a concentrated solution, stored under hazardous conditions and diluted for use. On-site PAA generation using nonhazardous ingredients can help eliminate transportation and storage issues at the processing plant and reduce the risk of occupational hazards. The objective of the proposed research was to 1) evaluate the efficacy of on-site generated PAA in reducing Salmonella and Campylobacter populations compared to the commercially available PAA stock solutions and 2) to perform color measurements to evaluate any deviations between treatments. PAA solutions at 50 and 100 ppm were used for treating the chicken wings. Fresh chicken wings (0.45 kg) were inoculated with a cocktail of nalidixic acid resistant Salmonella Typhimurium (STNR) and gentamicin resistant Campylobacter coli (CCGR) and immersed in PAA solutions (50 and 100 ppm) adjusted to pH 8.5 and 10.0 or 10.5, for either 10 s or 60 min. Treated chicken wings were rinsed for 1 min in chilled BPW (100 mL), serially diluted and plated on APC Petrifilm for Salmonella, spread plated on Campy-cefex agar supplemented with gentamicin (200 ppm) for Campylobacter enumeration. Immersion of chicken wings in 100 ppm PAA for 60 min irrespective of pH levels and PAA solutions resulted in greater microbial reductions (P < 0.05) of Salmonella by 1.68 and 1.42 log CFU/mL for SaniDate, 1.82 and 1.83 log CFU/mL for OxyFusion (on-site generated). For the same treatments, Campylobacter reductions of 1.59 and 1.36 log CFU/mL for SaniDate, 1.63 and 1.71 log CFU/mL for OxyFusion were achieved. The antimicrobial efficiency of PAA was not affected by pH and type of PAA solution. No significant differences (P > 0.05) in color were observed between treatments and controls. On-site generated PAA provides poultry processors an effective, safer, and less hazardous alternative to commercially available PAA solutions, ensuring poultry workers’ health and safety.
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Affiliation(s)
- S Vaddu
- Department of Poultry Science, University of Georgia, Athens, GA 30602
| | - J Kataria
- Department of Poultry Science, University of Georgia, Athens, GA 30602
| | - T S Belem
- Department of Poultry Science, University of Georgia, Athens, GA 30602
| | - G Sidhu
- Department of Poultry Science, University of Georgia, Athens, GA 30602
| | - A E Moller
- Department of Poultry Science, University of Georgia, Athens, GA 30602
| | - C Leone
- Department of Poultry Science, University of Georgia, Athens, GA 30602
| | - M Singh
- Department of Poultry Science, University of Georgia, Athens, GA 30602
| | - H Thippareddi
- Department of Poultry Science, University of Georgia, Athens, GA 30602.
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11
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Frega A, Pavone M, Sesti F, Leone C, Bianchi P, Cozza G, Colombrino C, Lukic A, Marziani R, De Sanctis L, Delli Carpini G, Caserta D, Ciavattini A. Sensitivity and specificity values of high-risk HPV DNA, p16/ki-67 and HPV mRNA in young women with atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion (LSIL). Eur Rev Med Pharmacol Sci 2021; 23:10672-10677. [PMID: 31858534 DOI: 10.26355/eurrev_201912_19765] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The aim of the study was to evaluate the sensitivity and specificity values of high-risk HPV DNA test, p16/ki-67, and HPV mRNA in histologically high-grade cervical intraepithelial lesions (CIN2-CIN3) in women aged 21-24 years with diagnosis of atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion (LSIL) at pap smear. PATIENTS AND METHODS 342 patients between 21-24 years old, attending spontaneously our clinics, 118 with ASCUS and 224 with LSIL, were enrolled in the study. All patients underwent colposcopy and biopsies were performed in the areas with major changes. All patients were tested at the same time for p16/ki-67, high-risk HPV DNA and HPV mRNA. RESULTS Nineteen out of 118 women with ASCUS showed a high-grade cervical intraepithelial lesion, 11 out of 118 (9.32%) CIN2, and 8 out of 118 (6.78%) CIN3. The sensitivity of high-risk HPV DNA was 99.9%, and the specificity 23.2%; p16/ki-67 pointed out a sensitivity of 90.9%, and a specificity of 81.8%; HPV mRNA showed a sensitivity of 81.8%, and specificity of 87.9% in CIN2 lesions. In CIN3 lesions, the sensitivity of high-risk HPV DNA was 99.9%, while the specificity was 19.1%; p16/ki-67 showed a sensitivity of 99.9%, and a specificity of 73.7%; HPV mRNA relived a sensitivity of 87.5%, and a specificity of 80.8%. In women with LSIL, a total of 42/224 (18.75%) of CIN2 were found at the histopathological examination, while 17/224 (7.59%) women presented a CIN3. No case of invasive cancer was identified. High-risk HPV DNA was positive in 190/224 (84.8%), p16/ki-67 in 119/224 (53.1%), and HPV mRNA in 104/224 (46.4%). In women with CIN2, the sensitivity of high-risk HPV DNA was of 92.8%, and the specificity 17.5%, the sensitivity of p16/ki-67 was 95.2%, and specificity 61.8%. HPV mRNA showed a sensitivity of 88.8% and a specificity of 87.8%. In women with CIN3, the sensitivity of high-risk HPV DNA was 88.2%, and the specificity 29.7%; p16/ki-67 pointed out a sensitivity of 94.1%, and a specificity of 49%; HPV mRNA showed a sensitivity of 88.2% and a specificity of 80.6. CONCLUSIONS Taking into account the high rate of spontaneous regression of high-grade lesions in young women, these tests, in particular, the HPV mRNA test, used as a triage test for ASCUS or LSIL, can modify follow-up triage strategy. In fact, this biomarker, due to its high specificity, could lead to a cytology repetition instead of an immediate colposcopy, avoiding over diagnosis and potential overtreatment in this category of women.
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Affiliation(s)
- A Frega
- Department of Surgery, Medicine and Translational Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
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12
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Noll PRES, Campos CAS, Leone C, Zangirolami-Raimundo J, Noll M, Baracat EC, Júnior JMS, Sorpreso ICE. Dietary intake and menopausal symptoms in postmenopausal women: a systematic review. Climacteric 2020; 24:128-138. [PMID: 33112163 DOI: 10.1080/13697137.2020.1828854] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Despite literature pointing to a relation between dietary intake and menopausal symptoms, most studies have evaluated either only supplements or only specific nutrients or foods. Therefore, this study aimed to provide a systematic review of the literature regarding the association between dietary intake and menopausal symptoms in postmenopausal women. A systematic search was conducted across PubMed/Medline, Web of Science, Scopus, and Embase to identify studies published between 2009 and 2019. We identified 3828 studies; after screening, 73 studies were reviewed and 19 of these investigated nutrient and food intake and eating patterns associated with the intensity of menopausal symptoms. Studies evaluating diet quality or dietary patterns showed an association between lower intensity of psychological symptoms, sleep disorders, and vasomotor, urogenital, and somatic symptoms and higher consumption of vegetables, whole grains, and unprocessed foods. Also, the intensity of these symptoms is associated with high-processed foods, saturated fats, and sugars. Regarding nutrient and/or specific food, the studies indicated an association between caffeine intake and type of fat intake and the intensity of menopausal symptoms. Dietary intake was found to be associated with the severity of menopausal symptoms; however, evidence for the association between dietary intake and menopausal symptoms is inconsistent and inconclusive, and is provided by a small number of studies.
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Affiliation(s)
- P R E S Noll
- Department of Obstetrics and Gynecology, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil.,Department of Public Health, Instituto Federal Goiano, Goiás, Brazil
| | - C A S Campos
- Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil
| | - C Leone
- Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil
| | - J Zangirolami-Raimundo
- Department of Obstetrics and Gynecology, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - M Noll
- Department of Public Health, Instituto Federal Goiano, Goiás, Brazil
| | - E C Baracat
- Department of Obstetrics and Gynecology, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - J M Soares Júnior
- Department of Obstetrics and Gynecology, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - I C E Sorpreso
- Department of Obstetrics and Gynecology, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
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Pasquini M, Fabbrini G, Moretti G, Berardelli I, Mandarelli G, Chiaie RD, Leone C, Biondi M, Berardelli A. Bradykinesia and Mental Slowness in Patients with Obsessive-compulsive Disorder. Eur Psychiatry 2020. [DOI: 10.1016/s0924-9338(09)71268-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Background:Clinical and experimental findings suggest that Obsessive-Compulsive Disorder (OCD) is due to an abnormality of the cortico-striato-thalamo-cortical circuit. Bradykinesia and mental slowness can be present in patients with basal ganglia disorders affecting the cortico-striato-thalamo-cortical circuit. Aim of this study is to investigate whether bradykinesia and mental slowness are present in patients with OCD.Methods:Participants comprised 19 non-depressed anti-psychotic free patients with OCD.Bradykinesia was assessed with the motor section of the Unified Parkinson's Disease Rating Scale (UPDRS). Mental slowness was investigated with the WAIS-R and the Y-BOCS. Psychiatric evaluation was performed with: SCID-I, Y-BOCS, HAMD, HAM-A, and MMPI. Cognitive functions were assessed with the WAIS-R.Results:Bradykinesia and mental slowness were present respectively in the 39% and 89% of the patients. Bradykinesia was positively correlated to Y-BOCS mental slowness score (rho=0.48, p< 0.05), and inversely related to the WAIS-R Performance IQ score (rho=-0.65, p< 0.01). Patients with bradykinesia scored significantly lower in the Similarities and Digit symbol coding WAIS-R subscales as compared to non-bradykinetic patients. in our sample pathological doubt was not associated with IQ measures nor with bradykinesia. Twelve out of 19 patients (63%) showed impairments in the nonverbal function scores.Conclusions:The novel findings of this study is that bradykinesia can be present in patients with OCD, and it is correlated with mental slowness and nonverbal performance impairment. These preliminary data support the notion that dysfunction of basal ganglia is possibly present in OCD patients.
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Frega A, Santomauro M, Sesti F, Di Giuseppe J, Colombrino C, Marziani R, Catalano A, Pavone M, Leone C, Mallozzi M, D'Adamo E, Ciavattini A, Caserta D. Preterm birth after loop electrosurgical excision procedure (LEEP): how cone features and microbiota could influence the pregnancy outcome. Eur Rev Med Pharmacol Sci 2019; 22:7039-7044. [PMID: 30402872 DOI: 10.26355/eurrev_201810_16176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE In the last years, the mean age of women who underwent cervical treatment for high-grade cervical intraepithelial neoplasia (CIN 2-3) is similar to the age of women having their first pregnancy. The aim of this study was to evaluate the risk of preterm birth in subsequent pregnancies after loop electrosurgical excision procedure (LEEP). PATIENTS AND METHODS From January 2013 to January 2016 the study identified a total of 1435 women, nulliparous, who underwent LEEP for CIN 2-3, and who wished to have their first pregnancy. Before surgery, the lengths of the cervix were calculated by transvaginal sonography. After the treatment, the dimension of the removed tissue was evaluated. During the pregnancy, all women carried out periodic transvaginal sonography and vaginal-cervical swabs. RESULTS The average age of patients was 31.96±5.24 years; the interval between the surgical procedure and pregnancy was 12.04±4.67 months; the gestational age at births was 37.53±2.91 weeks. The first vaginal and cervical swab performed during pregnancy was negative in 81.8% of patients. The most prevalent infections were related to C. Albicans, G. Vaginalis, and Group B Streptococcus (GBS). The rate of preterm delivery was significantly higher in women with a minor cervical length. CONCLUSIONS The length and the volume of cervical tissue excised have been shown to be directly related to the risk for preterm birth. Furthermore, vaginal infections and their persistence during pregnancy in women with a history of LEEP may be associated with an increased risk for preterm birth, compared with women with no history of LEEP.
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Affiliation(s)
- A Frega
- Department of Surgical and Medical Science and Translational Medicine, Sant'Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
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15
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Leone C, Dufour A, Fasolino A, Truini A, Cruccu G. Trigeminal small-fibre function assessed with cold evoked potentials (CEPs) in humans. Clin Neurophysiol 2019. [DOI: 10.1016/j.clinph.2018.09.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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16
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Fasolino A, Leone C, Di Lionardo A, Cruccu G, Truini A. Impairment of the endogenous pain-inhibitory control in patients with pain due to EhlerDanlos disease. Clin Neurophysiol 2019. [DOI: 10.1016/j.clinph.2018.09.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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17
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Di Lionardo A, Fasolino A, Leone C, Truini A, Cruccu G. Mechanical block of large myelinated fibres in healthy humans to demonstrate that paroxysmal pain is mediated by non-nociceptive fibres. Clin Neurophysiol 2019. [DOI: 10.1016/j.clinph.2018.09.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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18
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Cardoso J, Leone C. Nutritional status and growth of adolescents in southern Brazil. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.1798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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19
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Galosi E, La Cesa S, Di Stefano G, Karlsson P, Fasolino A, Leone C, Biasiotta A, Cruccu G, Truini A. A pain in the skin. Regenerating nerve sprouts are distinctly associated with ongoing burning pain in patients with diabetes. Eur J Pain 2018; 22:1727-1734. [PMID: 29885017 DOI: 10.1002/ejp.1259] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUNDS Patients with diabetic polyneuropathy commonly suffer from ongoing burning pain and dynamic mechanical allodynia. In this clinical and skin biopsy study, we aimed at assessing how intraepidermal regenerating nerve sprouts are associated with these two types of pain. METHODS We consecutively enrolled 85 patients with diabetic polyneuropathy. All patients underwent skin biopsy at the distal leg. Intraepidermal nerve fibres were immunostained with the anti-protein gene product 9.5 (PGP9.5) to quantify all intraepidermal nerve fibres, and the growth-associated protein 43 (GAP43) to quantify regenerating nerve sprouts. RESULTS We found that the GAP43-stained intraepidermal nerve fibre density and the ratio GAP43/PGP9.5 were significantly higher in patients with ongoing burning pain than in those without. The area of receiver operating characteristic (ROC) curve for the ratio GAP43/PGP9.5 was 0.74 and yielded a sensitivity and specificity for identifying ongoing burning pain of 72% and 71%, respectively. Conversely, although the density of PGP9.5 and GAP43 intraepidermal nerve fibre was higher in patients with dynamic mechanical allodynia than in those without, this difference was statistically weak and the ROC curve analysis of skin biopsy variables for this type of pain failed to reach the statistical significance. CONCLUSION Our clinical and skin biopsy study showed that ongoing burning pain was strongly associated with regenerating sprouts, as assessed with GAP43 immunostaining. This finding improves our understanding on the mechanisms underlying neuropathic pain in patients with diabetic polyneuropathy and suggests that the GAP43/PGP 9.5 ratio might be used as an objective marker for ongoing burning pain due to regenerating sprouts. SIGNIFICANCE Our skin biopsy study showing that regenerating sprouts, as assessed with GAP43-staining, were strongly associated with ongoing burning pain, improves our knowledge on the mechanisms underlying neuropathic pain in patients with diabetes.
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Affiliation(s)
- E Galosi
- Department Human Neuroscience, Sapienza University, Rome, Italy
| | - S La Cesa
- Department Human Neuroscience, Sapienza University, Rome, Italy
| | - G Di Stefano
- Department Human Neuroscience, Sapienza University, Rome, Italy
| | - P Karlsson
- Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Denmark.,Core Center for Molecular Morphology, Section for Stereology and Microscopy, Department of Clinical Medicine, Aarhus University, Denmark
| | - A Fasolino
- Department Human Neuroscience, Sapienza University, Rome, Italy
| | - C Leone
- Department Human Neuroscience, Sapienza University, Rome, Italy
| | - A Biasiotta
- Department Human Neuroscience, Sapienza University, Rome, Italy
| | - G Cruccu
- Department Human Neuroscience, Sapienza University, Rome, Italy
| | - A Truini
- Department Human Neuroscience, Sapienza University, Rome, Italy
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La Cesa S, Di Stefano G, Leone C, Pepe A, Galosi E, Alu F, Fasolino A, Cruccu G, Valeriani M, Truini A. Skin denervation does not alter cortical potentials to surface concentric electrode stimulation: A comparison with laser evoked potentials and contact heat evoked potentials. Eur J Pain 2017; 22:161-169. [DOI: 10.1002/ejp.1112] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2017] [Indexed: 01/20/2023]
Affiliation(s)
- S. La Cesa
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
| | - G. Di Stefano
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
| | - C. Leone
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
| | - A. Pepe
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
| | - E. Galosi
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
| | - F. Alu
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
| | - A. Fasolino
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
| | - G. Cruccu
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
| | - M. Valeriani
- Ospedale Bambino Gesù; IRCCS; Rome Italy
- Center for Sensory-Motor Interaction; Aalborg University; Denmark
| | - A. Truini
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
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Suppa A, Leone C, Di Stasio F, Marsili L, Di Santo A, Biasiotta A, La Cesa S, Truini A, Cruccu G, Berardelli A. Pain-motor integration in the primary motor cortex in Parkinson's disease. Brain Stimul 2017; 10:806-816. [DOI: 10.1016/j.brs.2017.04.130] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 02/07/2017] [Accepted: 04/27/2017] [Indexed: 01/14/2023] Open
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Carlesimo SC, Piazzi G, Leone C, Di Santo L, Coccanari dè Fornari MA. [Masuda's Central Serous Chorioretinopathy (C.S.C.R.) and its somatic investment in Narcissism: our observations on new psychiatric nosography]. Clin Ter 2016; 165:27-30. [PMID: 24589947 DOI: 10.7471/ct.2014.1657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Case report. Co-morbidity between central serous chorioretinopathy (C.R.S.C.) and narcissistic personality disorder. A reflection on the importance of an integrated approach to this ophthalmological disease through the description of its psychosomatic aspects and the evaluation of the nosographic definition in psychiatry. The central serous chorioretinopathy (C.R.S.C.) is a transudative disease affecting the posterior pole of the eye, that rapidly compromises the visual acuity, although it is a self-limited disease. Narcissism is a personality disorder characterised by an extreme gratification of self, without actually taking care of other people. In the current work both the diseases, along with the respective psychosomatic consequences the patient received, are examined.
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Affiliation(s)
- S C Carlesimo
- Dipartimenti di Scienze Oftalmologiche, Ia Facoltà di Medicina e Chirurgia, "Sapienza" Università di Roma, Italia
| | - G Piazzi
- Dipartimenti di Neurologia e Psichiatria, Ia Facoltà di Medicina e Chirurgia, "Sapienza" Università di Roma, Italia
| | - C Leone
- Dipartimenti di Neurologia e Psichiatria, Ia Facoltà di Medicina e Chirurgia, "Sapienza" Università di Roma, Italia
| | - L Di Santo
- Disegnatore scientifico freelance, Roma Italia
| | - M A Coccanari dè Fornari
- Dipartimenti di Neurologia e Psichiatria, Ia Facoltà di Medicina e Chirurgia, "Sapienza" Università di Roma, Italia
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Pepe A, Leone C, Di Stefano G, Celletti C, Baron R, Castori M, Di Franco M, La Cesa S, Cruccu G, Truini A, Camerota F. 39. Central sensitization as the mechanism underlying pain in joint hypermobility syndrome/Ehlers–Danlos syndrome, hypermobility type. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2016.10.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Pepe A, Di Stefano G, La Cesa S, Leone C, D’Antonio F, Trebbastoni, De Lena C, Cruccu G, Truini A. 43. Pain-related cortex function in patients with Alzheimer’s disease. Preliminary results. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.09.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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25
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Leone C, Di Stefano G, Biasiotta A, La Cesa S, Piroso S, Pepe A, Tartaglia G, Gori M, Onesti M, Inghilleri M, Cruccu G, Truini A. 54. Dronabinol inhibits nociceptive transmission in humans. A double blind randomized controlled study. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.09.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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26
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Leone C, Di Stefano G, Biasiotta A, La Cesa S, Piroso S, Pepe A, Tartaglia G, Gori M, Onesti M, Inghilleri M, Cruccu G, Truini A. ID 349 – Dronabinol inhibits nociceptive transmission in humans. A double blind randomized controlled study. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.11.379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Di Stefano G, Pepe A, La Cesa S, Leone C, D’Antonio F, Trebbastoni A, De Lena C, Cruccu G, Truini A. ID 246 – Pain-related cortex function in patients with Alzheimer disease. Preliminary results. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.11.393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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28
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La Cesa S, Biasiotta A, Onesti E, Di Stefano G, Ceccanti M, Leone C, Giordano G, Cruccu G, Inghilleri M, Truini A. ID 262 – Small-fiber neuropathy related to bulbar and spinal-onset in patients with ALS. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.11.305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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29
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Di Stefano G, Celletti C, Baron R, Castori M, Di Franco M, La Cesa S, Leone C, Pepe A, Cruccu G, Truini A, Camerota F. Central sensitization as the mechanism underlying pain in joint hypermobility syndrome/Ehlers-Danlos syndrome, hypermobility type. Eur J Pain 2016; 20:1319-25. [DOI: 10.1002/ejp.856] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2016] [Indexed: 12/25/2022]
Affiliation(s)
- G. Di Stefano
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
| | - C. Celletti
- Physical Medicine and Rehabilitation Division; Policlinico Umberto I; Sapienza University; Rome Italy
| | - R. Baron
- Division of Neurological Pain Research and Therapy; Universitätsklinikum Schleswig-Holstein; Kiel Germany
| | - M. Castori
- Division of Medical Genetics; Department of Molecular Medicine; San Camillo-Forlanini Hospital; Sapienza University; Rome Italy
| | - M. Di Franco
- Rheumatology Unit; Department of Internal Medicine and Medical Specialities; Sapienza University; Rome Italy
| | - S. La Cesa
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
| | - C. Leone
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
| | - A. Pepe
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
| | - G. Cruccu
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
| | - A. Truini
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
| | - F. Camerota
- Physical Medicine and Rehabilitation Division; Policlinico Umberto I; Sapienza University; Rome Italy
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Veiga CS, Coutinho DS, Nakaie CMA, Campos LMA, Suzuki L, Cunha MT, Leone C, Silva CA, Rodrigues JC. Subclinical pulmonary abnormalities in childhood-onset systemic lupus erythematosus patients. Lupus 2016; 25:645-51. [DOI: 10.1177/0961203316629554] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Accepted: 01/07/2016] [Indexed: 01/22/2023]
Abstract
Objective The aims of this study were to analyze the pulmonary function of childhood-onset systemic lupus erythematosus (cSLE) patients and to identify possible correlations between the high-resolution computed chest tomography (HRCT) score, disease activity, disease cumulative damage, and the participants’ quality of life. Methods Forty cSLE patients, median age: 14.1 years (range: 7.4–17.9), underwent spirometry and plethysmography. Carbon monoxide diffusing capacity (DLCO), HRCT, disease activity, disease cumulative damage, and quality of life were assessed. Results Pulmonary abnormalities were evident in 19/40 (47.5%) cSLE patients according to spirometry/DLCO. Forced expired volume in one second (FEV1%) was the parameter most affected (30%). The HRCT showed some abnormality in 22/30 patients (73%), which were minimal in 43%. Signs of airway affects were found in 50%. Twelve patients were hospitalized due to cSLE-related pulmonary complications before the study began (median discharge: 2.1 years earlier). Total lung capacity (TLC%), vital capacity (VC%), forced vital capacity (FVC%), and FEV1% were significantly lower in the group with hospitalization compared to the group without hospitalization ( p = 0.0025, p = 0.0022, p = 0.0032, and p = 0.0004, respectively). Of note, DLCO was positively correlated with disease duration ( r = +0.4; p = 0.01). The HRCT-score was negatively correlated with FEV1/VC ( r = −0.63; p = 0.0002), FEV1 ( r = −0.54; p = 0.018), FEF25%–75% ( r = −0.67; p < 0.0001), and HRCT-score was positively correlated with resistance ( r = +0.49; p = 0.0056). Conclusions Almost half of patients with cSLE had subclinical pulmonary abnormalities, especially airway abnormalities. The cSLE-related pulmonary complications seem to determine long-term functional damage.
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Affiliation(s)
- C S Veiga
- Pediatric Pulmonology Unit, Instituto da Criança do Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
| | - D S Coutinho
- Pediatric Pulmonology Unit, Instituto da Criança do Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
| | - C M A Nakaie
- Pediatric Pulmonology Unit, Instituto da Criança do Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
| | - L M A Campos
- Pediatric Rheumatology Unit, Instituto da Criança do Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
| | - L Suzuki
- Department of Radiology, Instituto da Criança do Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
| | - M T Cunha
- Physical Therapy Service, Instituto da Criança do Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
| | - C Leone
- Department of Maternal and Child Health, College of Public Health, University of São Paulo, Brazil
| | - C A Silva
- Pediatric Rheumatology Unit, Instituto da Criança do Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
| | - J C Rodrigues
- Pediatric Pulmonology Unit, Instituto da Criança do Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
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D'Amico E, Patti F, Leone C, Lo Fermo S, Zappia M. Negative prognostic impact of MRI spinal lesions in the early stages of relapsing-remitting multiple sclerosis. Mult Scler J Exp Transl Clin 2016; 2:2055217316631565. [PMID: 28607716 PMCID: PMC5408896 DOI: 10.1177/2055217316631565] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The presence of spinal cord (SC) magnetic resonance imaging (MRI) lesions can be expected to affect the mobility of people with relapsing-remitting MS (pwRRMS), but reports are ambiguous. OBJECTIVE The objective of this paper is to determine whether the presence of SC MRI lesions in early diagnosed pwRRMS could be considered a predictor of long-term disability. METHODS pwRRMS with an SC MRI performed within two years from the onset of symptoms and followed up for at least seven years were included. Patients were grouped into: (a) pwRRMs with at least one SC T2 MRI lesion, and (b) pwRRMs without SC T2 MRI lesions. The primary end point was to evaluate the effects of independent factors on reaching an Expanded Disability Status Score (EDSS) of 4.0. RESULTS A total of 239 pwRRMS matched the required criteria: 116 in the group with SC lesions and 123 in the group without SC lesions. At baseline, there were no statistical differences between the two groups. The presence of SC lesions (Exp(b) 4.4, CI 2.1-9.0, p < 0.001) and higher basal EDSS (Exp(b) 3.3, CI 2.3-4.8, p < 0.001) proved to be the best predictors of reaching EDSS 4.0. CONCLUSION The presence of T2 SC MRI lesions detected early from MS onset of RRMS predicts a worse prognosis.
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Affiliation(s)
| | - F Patti
- University of Catania, Italy
| | - C Leone
- University of Catania, Italy
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da Veiga C, Coutinho D, Nakaie C, Campos L, Suzuki L, Leone C, Silva C, Rodrigues J. SAT0511 Pulmonary Abnormalities in Childhood-Onset Systemic Lupus Erythematosus Patients. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Astarita A, Genna S, Leone C, Minutolo FMC, Rubino F, Squillace A. Study of the Laser Remelting of a Cold Sprayed Titanium Layer. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.procir.2015.06.101] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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34
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Biasiotta A, Leone C, La Cesa S, Pepe A, Galosi E, Piroso S, Di Stefano G, Giordano C, Cruccu G, Truini A. 67. Does the epidermal nerve fibre density measured by skin biopsy in patients with peripheral neuropathies correlate with neuropathic pain? Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2014.10.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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35
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Di Stefano G, Biasiotta A, La Cesa S, Leone C, Pepe A, Piroso S, Truini A, Cruccu G. 61. Natural history and outcome of 200 outpatients with classical trigeminal neuralgia treated with carbamazepine or oxcarbazepine in a tertiary centre for neuropathic pain. Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2014.10.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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36
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Biasiotta A, Truini A, Leone C, Federico V, La Cesa S, Russo E, Di Stefano G, Pepe A, Finsinger P, Labriola R, Piroso S, Cruccu G, Petrucci M. 57. An observational study assessing definitively diagnosed peripheral neuropathy and neuropathic pain in patients with multiple myeloma. Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2014.10.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mandolfino C, Lertora E, Genna S, Leone C, Gambaro C. Effect of Laser and Plasma Surface Cleaning on Mechanical Properties of Adhesive Bonded Joints. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.procir.2015.06.054] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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38
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Genna S, Leone C, Palumbo B, Tagliaferri F. Statistical Approach to Fiber Laser Microcutting of NIMONIC® C263 Superalloy Sheet Used in Effusion Cooling System of Aero Engines. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.procir.2015.06.067] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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39
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Leone C, Pennisi E, Biasiotta A, Antonini G, La Cesa S, Stefano GD, Piroso S, Pepe A, Raffa S, Sommer C, Truini A, Cruccu G. 62. Idiopathic trigeminal sensory neuropathy and fosmn syndrome. Despite a dissimilar disease course do they share common pathophysiological mechanisms? Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2014.10.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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40
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Zamberlan P, Feferbaum R, Delgado A, Leone C, de Carvalho W. PP261-MON: Arm Measures are Better Undernutrition Anthropometric Indicators of the Critically Ill Children and Adolescents Nutritional Status in Pediatric Intensive Care Unit. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50595-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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41
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Zamberlan P, Feferbaum R, Delgado A, Leone C, de Carvalho W. PP262-MON: Fat-Free Body Mass as a Mortality Predictor in Critically Ill Children and Adolescents. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50596-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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42
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Leone C, Biasiotta A, Piroso S, La Cesa S, Di Stefano G, Truini A, Cruccu G. P986: Paroxysmal pain is mediated by non-nociceptive large myelinated fibres. A neurophysiological study in normal humans. Clin Neurophysiol 2014. [DOI: 10.1016/s1388-2457(14)51023-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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43
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Piroso S, Leone C, Pasquale E, Di Stefano G, Cruccu G, Nicoletti F, Truini A, Pasquale E. P984: N-acetyl-cysteine inhibits nociceptive pathway function. A combined animal and human study. Clin Neurophysiol 2014. [DOI: 10.1016/s1388-2457(14)51021-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Truini A, Biasiotta A, Di Stefano G, Leone C, La Cesa S, Galosi E, Piroso S, Pepe A, Giordano C, Cruccu G. Does the epidermal nerve fibre density measured by skin biopsy in patients with peripheral neuropathies correlate with neuropathic pain? Pain 2014; 155:828-832. [DOI: 10.1016/j.pain.2014.01.022] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Revised: 01/23/2014] [Accepted: 01/27/2014] [Indexed: 01/15/2023]
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45
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Biasiotta A, Casato M, La Cesa S, Colantuono S, Di Stefano G, Leone C, Carlesimo M, Piroso S, Cruccu G, Truini A. Clinical, neurophysiological, and skin biopsy findings in peripheral neuropathy associated with hepatitis C virus-related cryoglobulinemia. J Neurol 2014; 261:725-31. [PMID: 24500496 DOI: 10.1007/s00415-014-7261-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2013] [Revised: 01/21/2014] [Accepted: 01/22/2014] [Indexed: 01/14/2023]
Abstract
Hepatitis C virus (HCV)-related cryoglobulinemia commonly causes disabling complications including peripheral neuropathy and neuropathic pain. In this prospective clinical, neurophysiological, and skin biopsy study we aimed at assessing clinical characteristics and risk factors of peripheral neuropathy and neuropathic pain in patients with HCV-related cryoglobulinemia. We enrolled 69 consecutive patients with HCV-related cryoglobulinemia. We diagnosed neuropathic pain with the DN4 (Neuropathic Pain Diagnostic) questionnaire, and rated the various neuropathic pains with the Neuropathic Pain Symptom Inventory (NPSI). All patients underwent a standard nerve conduction study to assess Aβ-fiber function, laser-evoked potentials to assess Aδ-fiber function, and skin biopsy to assess C-fiber terminals. Of the 69 patients studied, 47 had a peripheral neuropathy, and 29 had neuropathic pain. Patients with peripheral neuropathy were older than those without (P < 0.0001). While peripheral neuropathy was significantly associated with the duration of HCV infection (P < 0.01), it was unrelated to the duration of cryoglobulinemia and cryocrit (P > 0.5). The severity of peripheral neuropathy significantly correlated with the duration of HCV infection (P < 0.05). Laser-evoked potential amplitudes were significantly lower in patients with than in those without neuropathic pain (P < 0.05). Conversely, no difference was found in nerve conduction study and skin biopsy findings (P > 0.05). Our findings show that peripheral neuropathy is related to age and HCV infection, rather than to cryoglobulinemia, and neuropathic pain is associated with damage to nociceptive pathways as assessed with laser-evoked potentials; this might be useful for designing more effective clinical interventions for these common HCV related-cryoglobulinemia complications.
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Affiliation(s)
- A Biasiotta
- Department of Neurology and Psychiatry, Sapienza University, Viale Università 30, 00185, Rome, Italy
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Gonçalves-Ferri WA, Martinez FE, Caldas JPS, Marba STM, Fekete S, Rugolo L, Tanuri C, Leone C, Sancho GA, Almeida MFB, Guinsburg R. Application of continuous positive airway pressure in the delivery room: a multicenter randomized clinical trial. ACTA ACUST UNITED AC 2014; 47:259-64. [PMID: 24554040 PMCID: PMC3982948 DOI: 10.1590/1414-431x20133278] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 11/04/2013] [Indexed: 11/22/2022]
Abstract
This study evaluated whether the use of continuous positive airway pressure (CPAP) in the delivery room alters the need for mechanical ventilation and surfactant during the first 5 days of life and modifies the incidence of respiratory morbidity and mortality during the hospital stay. The study was a multicenter randomized clinical trial conducted in five public university hospitals in Brazil, from June 2008 to December 2009. Participants were 197 infants with birth weight of 1000-1500 g and without major birth defects. They were treated according to the guidelines of the American Academy of Pediatrics (APP). Infants not intubated or extubated less than 15 min after birth were randomized for two treatments, routine or CPAP, and were followed until hospital discharge. The routine (n=99) and CPAP (n=98) infants studied presented no statistically significant differences regarding birth characteristics, complications during the prenatal period, the need for mechanical ventilation during the first 5 days of life (19.2 vs 23.4%, P=0.50), use of surfactant (18.2 vs 17.3% P=0.92), or respiratory morbidity and mortality until discharge. The CPAP group required a greater number of doses of surfactant (1.5 vs 1.0, P=0.02). When CPAP was applied to the routine group, it was installed within a median time of 30 min. We found that CPAP applied less than 15 min after birth was not able to reduce the need for ventilator support and was associated with a higher number of doses of surfactant when compared to CPAP applied as clinically indicated within a median time of 30 min.
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Affiliation(s)
- W A Gonçalves-Ferri
- Departamento de Pediatria, Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo, Ribeirao Preto, SP, Brasil
| | - F E Martinez
- Departamento de Pediatria, Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo, Ribeirao Preto, SP, Brasil
| | - J P S Caldas
- Departamento de Pediatria, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - S T M Marba
- Departamento de Pediatria, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - S Fekete
- Departamento de Pediatria, Universidade Estadual de Sao Paulo, Botucatu, SP, Brasil
| | - L Rugolo
- Departamento de Pediatria, Universidade Estadual de Sao Paulo, Botucatu, SP, Brasil
| | - C Tanuri
- Maternidade Hospital Cachoeirinha, Sao Paulo, SP, Brasil
| | - C Leone
- Departamento de Pediatria, Universidade de Sao Paulo, SP, Brasil
| | - G A Sancho
- Departamento de Pediatria, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brasil
| | - M F B Almeida
- Departamento de Pediatria, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brasil
| | - R Guinsburg
- Departamento de Pediatria, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brasil
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Piroso S, Fasolina A, Minichino A, Stefano GD, Leone C, Chiaie SD, Cruccu G, Truini A. 16. Processing of nociceptive input in schizophrenic patients: Preliminary results. Clin Neurophysiol 2013. [DOI: 10.1016/j.clinph.2013.06.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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48
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Biasiotta A, Busto G, Celletti C, Stefano GD, Leone C, Cesa SL, Piroso S, Cruccu G, Castori M, Camerota F, Truini A. 37. A clinical and neurophysiological study of pain in patients with Ehlers Danlos syndrome. Clin Neurophysiol 2013. [DOI: 10.1016/j.clinph.2013.06.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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49
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Leone C, Galosi E, Stefano GD, Cesa SL, Biasiotta A, Piroso S, Cruccu G, Truini A. 15. Paroxysmal pain is mediated by non-nociceptive large myelinated fibres: A neurophysiological study in normal humans. Clin Neurophysiol 2013. [DOI: 10.1016/j.clinph.2013.06.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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50
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Truini A, Biasiotta A, Di Stefano G, La Cesa S, Leone C, Cartoni C, Leonetti F, Casato M, Pergolini M, Petrucci MT, Cruccu G. Peripheral nociceptor sensitization mediates allodynia in patients with distal symmetric polyneuropathy. J Neurol 2012; 260:761-6. [PMID: 23052607 DOI: 10.1007/s00415-012-6698-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Revised: 09/26/2012] [Accepted: 09/28/2012] [Indexed: 10/27/2022]
Abstract
Patients with painful neuropathy frequently complain of pain in response to normally non-painful brushing, namely dynamic mechanical allodynia. Despite many animal studies suggesting that allodynia arises when the spontaneous firing in damaged nociceptive afferents sensitise second-order nociceptive neurons to Aβ-fibre input, no studies have sought to confirm this mechanism by investigating Aβ-fibre sparing in human patients with allodynia. In this study we compared data from Aβ-fibre-mediated nerve conduction studies and nociceptive-fibre-mediated laser-evoked potentials (LEPs) in 200 patients with distal symmetric polyneuropathy (114 with neuropathic pain, 86 without). Of the 114 patients with painful neuropathy studied, 44 suffered from allodynia. Whereas no statistical difference was found in nerve conduction study data between patients with and without allodynia, LEP amplitudes were larger in patients with allodynia than in those without (P < 0.01 by Mann-Whitney U test). The lack of difference in NCS data between patients with and without allodynia suggest that this type of pain, rather than arising through second-order nociceptive neuron sensitization to Aβ-fibre input, might reflect a reduced mechanical threshold in sensitised intraepidermal nociceptive nerve terminals.
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Affiliation(s)
- A Truini
- Department of Neurology and Psychiatry, Sapienza University, Viale Università 30, 00185, Rome, Italy
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